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HERMAPHRODITISM
PRESENTED BY:
BALOGUN, Wasiu Gbolahan
(07/46KA027)
Anatomy Department,
Faculty of B.M.S,
University of Ilorin. 1
OUTLINE
Introduction
Human sexual development
Classification
Images of hermaphrodite
Causes
Defects
Diagnosis
 Prevention
Treatment
Social and Legal implications
Conclusion
References
2
INTRODUCTION
Hermaphroditism is defined as a congenital disorder
in which the development of chromosomal, gonadal,
or anatomical sex is atypical.
It is the discrepancy that occur between the
morphology of the gonads and the appearance of the
external genitalia (Moore and Persaud, 2008).
Recently, the word intersex has come into
preferential usage in humans as hermaphroditism is
found misleading.
3
HUMAN SEXUAL DEVELOPMENT
Chromosomal sex
Gonadal sex
External genital sexInternal genital sex
SEX ASSIGNMENT
Gender identity
and role
Sex of rearing
(Yousef, 2009) 4Table 1:sex development
CLASSIFICATION
Hermaphroditism can be classified into 4:
True hermaphrodite
Male Pseudohermaphroditism
Female Pseudohermaphroditism
Androgen insensitivity syndrome (AIS) which
can be subdivided into
•Complete
•Mild
•Partial
(Anand , 2008) 5
IMAGES OF HERMAPHRODITES
Fig 1:Image of a male pseudohermaphrodite
(Yousef , 2008) 6
Fig 2:The external genitalia of a true
hermaphrodite showing both male and female
sex organs (Yousef , 2009) 7
Fig 3: Picture of a female pseudohermaphrodite
(Moore and Persaud, 2008)
8
Fig 4:Picture of a patient with Androgen
Insensitivity Syndrome (Sadler, 2008) 9
CAUSES
They include:
Error in sex determination (Moore and Persaud, 2008)
Congenital adrenal hyperplasia (Allen, 2008)
Male hormones taken or encountered by the
mother during pregnancy (Allen, 2008)
Excessive exposure of the female foetus to
androgens (Sadler, 2008)
Genetic mutation
10
DEFECTS
All hermaphrodites have some defect in common
which include
•Infertility
•Risk of malignant tumour
•Amenorrhoea
True hermaphrodite have a cystic ovary-like gonad,
AIS experience hirsutism, female
pseudohermaphrodites have a small persistent
urogenital sinus while the male
pseudohermaphrodites have an unicorn uterus.
11
DIAGNOSIS
They can be diagnosed by
Karyotype analysis
Specific molecular testing
Gonadal biopsy
Endoscopic examination
Ultrasound
Federman’s rule
(Kliegman et al., 2007)
12
PREVENTION
Hermaphroditism is preventable, women having
unprotected sex, pregnant women, sportsmen and
sportswomen should not consume steroid drugs no
matter it concentration as it is injurious to the
developing child.
13
TREATMENT
Different methods have been devised, they include
Medications
Behavioural therapies
Intensive community support
Breast replacement surgery
Surgical correction of the genitalia
Vaginal repair and construction
Orchidectomy
14
SOCIALAND LEGAL IMPLICATIONS
Intersex people are treated in different ways by
different cultures. In some cultures, they have to
conform to either a female or a male gender role
(Gagnon and Simon, 1973).
Intersex has been subjected to undergo test which
are humiliating genital photography as in Caster
semanya case (Bryant, 2009). If the patient is managed
incorrectly, she or he may be doomed to live as a sex
freak (Yousef, 2009).
Intersex is a complex issue and its treatment has
short- and long-term consequences. 15
CONCLUSION
 Hermaphroditism is a form of genetic deception
 Prevention is better than cure, hermaphroditism
is real.
16
References
Allen L.(2009). Disorders of sexual development.
Obstet Gynecol Clin North Am. 36:25-45.
Anand S. (2008). Oxford Concise Medical
Dictionary 6th Edition.
Bryant Tom (2009). "Caster Semenya subjected to
'humiliating' sex test, claims coach". The Guardian
(London).
Gagnon and Simon (1973). Sex, Sexual instruction,
socialization and homosexuality. Aldine pub.co
(Chicago), 310-14
Intersex Society of North America (2006): A world
free of shame, secrecy, and unwanted genital surgery.
17
Kliegman et al., (2007). Nelson Textbook of
Pediatrics. 18th ed. Philadelphia, Pa: Saunders
Elsevier; chap 589.
Michidelis et al., (1984). “Inguinal hernia leading to
the diagnosis of internal male pseudo
hermaphroditism” Acta chir. Belg. 84 (4): 255-8.
Moore and Persaud (2008). Clinically oriented
anatomy :the developing human 8th edition 273-5
Thomas Sadler (2008). Langman's medical
embryology. Hagerstown, MD: Lippincott Williams &
Wilkins. p. 252
Yousef Jehad, (2009). intersexuality powerpoint
presentation Alhayat ART Center Amman Jordan
18
THANK YOU FOR YOUR
ATTENTION
19

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Hermaphroditism

  • 1. HERMAPHRODITISM PRESENTED BY: BALOGUN, Wasiu Gbolahan (07/46KA027) Anatomy Department, Faculty of B.M.S, University of Ilorin. 1
  • 2. OUTLINE Introduction Human sexual development Classification Images of hermaphrodite Causes Defects Diagnosis  Prevention Treatment Social and Legal implications Conclusion References 2
  • 3. INTRODUCTION Hermaphroditism is defined as a congenital disorder in which the development of chromosomal, gonadal, or anatomical sex is atypical. It is the discrepancy that occur between the morphology of the gonads and the appearance of the external genitalia (Moore and Persaud, 2008). Recently, the word intersex has come into preferential usage in humans as hermaphroditism is found misleading. 3
  • 4. HUMAN SEXUAL DEVELOPMENT Chromosomal sex Gonadal sex External genital sexInternal genital sex SEX ASSIGNMENT Gender identity and role Sex of rearing (Yousef, 2009) 4Table 1:sex development
  • 5. CLASSIFICATION Hermaphroditism can be classified into 4: True hermaphrodite Male Pseudohermaphroditism Female Pseudohermaphroditism Androgen insensitivity syndrome (AIS) which can be subdivided into •Complete •Mild •Partial (Anand , 2008) 5
  • 6. IMAGES OF HERMAPHRODITES Fig 1:Image of a male pseudohermaphrodite (Yousef , 2008) 6
  • 7. Fig 2:The external genitalia of a true hermaphrodite showing both male and female sex organs (Yousef , 2009) 7
  • 8. Fig 3: Picture of a female pseudohermaphrodite (Moore and Persaud, 2008) 8
  • 9. Fig 4:Picture of a patient with Androgen Insensitivity Syndrome (Sadler, 2008) 9
  • 10. CAUSES They include: Error in sex determination (Moore and Persaud, 2008) Congenital adrenal hyperplasia (Allen, 2008) Male hormones taken or encountered by the mother during pregnancy (Allen, 2008) Excessive exposure of the female foetus to androgens (Sadler, 2008) Genetic mutation 10
  • 11. DEFECTS All hermaphrodites have some defect in common which include •Infertility •Risk of malignant tumour •Amenorrhoea True hermaphrodite have a cystic ovary-like gonad, AIS experience hirsutism, female pseudohermaphrodites have a small persistent urogenital sinus while the male pseudohermaphrodites have an unicorn uterus. 11
  • 12. DIAGNOSIS They can be diagnosed by Karyotype analysis Specific molecular testing Gonadal biopsy Endoscopic examination Ultrasound Federman’s rule (Kliegman et al., 2007) 12
  • 13. PREVENTION Hermaphroditism is preventable, women having unprotected sex, pregnant women, sportsmen and sportswomen should not consume steroid drugs no matter it concentration as it is injurious to the developing child. 13
  • 14. TREATMENT Different methods have been devised, they include Medications Behavioural therapies Intensive community support Breast replacement surgery Surgical correction of the genitalia Vaginal repair and construction Orchidectomy 14
  • 15. SOCIALAND LEGAL IMPLICATIONS Intersex people are treated in different ways by different cultures. In some cultures, they have to conform to either a female or a male gender role (Gagnon and Simon, 1973). Intersex has been subjected to undergo test which are humiliating genital photography as in Caster semanya case (Bryant, 2009). If the patient is managed incorrectly, she or he may be doomed to live as a sex freak (Yousef, 2009). Intersex is a complex issue and its treatment has short- and long-term consequences. 15
  • 16. CONCLUSION  Hermaphroditism is a form of genetic deception  Prevention is better than cure, hermaphroditism is real. 16
  • 17. References Allen L.(2009). Disorders of sexual development. Obstet Gynecol Clin North Am. 36:25-45. Anand S. (2008). Oxford Concise Medical Dictionary 6th Edition. Bryant Tom (2009). "Caster Semenya subjected to 'humiliating' sex test, claims coach". The Guardian (London). Gagnon and Simon (1973). Sex, Sexual instruction, socialization and homosexuality. Aldine pub.co (Chicago), 310-14 Intersex Society of North America (2006): A world free of shame, secrecy, and unwanted genital surgery. 17
  • 18. Kliegman et al., (2007). Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; chap 589. Michidelis et al., (1984). “Inguinal hernia leading to the diagnosis of internal male pseudo hermaphroditism” Acta chir. Belg. 84 (4): 255-8. Moore and Persaud (2008). Clinically oriented anatomy :the developing human 8th edition 273-5 Thomas Sadler (2008). Langman's medical embryology. Hagerstown, MD: Lippincott Williams & Wilkins. p. 252 Yousef Jehad, (2009). intersexuality powerpoint presentation Alhayat ART Center Amman Jordan 18
  • 19. THANK YOU FOR YOUR ATTENTION 19